Docs warn some: Step away from the shovel

From the Boston Herald:

That’s heart-attack snow out there, heavy and wet, the experts say.

Docs say the best way to shovel for both your heart and your back is to pay a 16-year-old. But if you insist on moving the stuff yourself, here are some things to think about.

“A lot of people are out of shape and don’t realize how heavy the (physical) demand is,” said Assaad Sayah, chief of emergency medicine for Cambridge Health Alliance.

He said the messy, wet snow dropped around Boston overnight is exactly the kind that health-care professionals fear . . . it raises the likelihood that they’ll have some heavy lifting to do themselves in the ER today.

Couch potatoes who pick up their shovels without taking precautions account for an increase of up to 20 percent in the number of patients showing up in emergency rooms with heart attacks.

Keep a visit to the ER out of your holiday plans

Some good advice from TampaBay.com.  Top 4 ways to avoid the ER:

1.  If traveling, don’t forget your medication.

2.  Use caution if you get out the ladder.

3.  Don’t drink and drive.

4.  If it’s been a year since you’ve seen Grandma, she’s aged since you’ve seen her last.  This doesn’t necessarily mean she needs to go to the hospital.

Full story here.

Doctor’s lawsuit against medical examiner tossed

From The Des Moines Register:

Woodbury County’s medical examiner had the right to notify state regulators of his suspicions that a local surgeon’s mistakes contributed to three patient deaths, a federal judge ruled this week.

Judge Linda Reade threw out a libel lawsuit filed last year by the surgeon, Dr. Ralph Reeder, against the longtime medical examiner, Dr. Thomas Carroll.

State medical regulators had worried that the lawsuit would discourage other doctors from reporting concerns about their colleagues’ possible malpractice.

The Iowa Board of Medicine, which licenses physicians, charged Reeder with incompetence in 2008, then withdrew the charges for lack of evidence. Reeder denied the allegations. He sued Carroll after learning that the licensing board’s investigation had been sparked by a 2004 letter from the medical examiner. Carroll, who performed autopsies on two of the three patients, suggested in the letter that the surgeon’s spinal operations contributed to the deaths.

Reeder said in his lawsuit that he spent more than $200,000 defending himself against false allegations that damaged his reputation in the Sioux City area. He contended Carroll wrote the letter out of spite, partly because Reeder was a co-owner of a small South Dakota hospital that the medical examiner believed was unfairly drawing business away from Sioux City hospitals.

Chief U.S. District Judge Linda Reade dismissed Reeder’s lawsuit Tuesday. She noted that physicians are required to tell regulators if they believe a colleague has committed malpractice. State law says people who file such reports “shall not be civilly liable as a result of filing a report with the board, so long as such report is not made with malice,” she wrote.

Mark Bowden, the medical board’s executive director, said such lawsuits crop up from time to time. They always raise fears that health professionals will hesitate to tell regulators about suspected malpractice. “This decision hopefully will reduce the chilling effect,” he said.

Reeder’s lawyer, Charles Patterson, said he hadn’t decided whether to appeal the decision. He said the surgeon is an excellent doctor whose work had never been questioned before. “He is really, in every sense of the word, a victim of circumstances he couldn’t control,” Patterson said.

Doctor Arrested in Whistle-Blowing Case

From the New York Times:

Texas officials have filed criminal charges against a West Texas physician over accusations that they say he orchestrated against two nurses who had filed a complaint against him with the state medical board.

The physician, Dr. Rolando G. Arafiles Jr., who practices at Winkler County Memorial Hospital in Kermit, Tex., was charged late Tuesday by the state attorney general’s office with retaliation and misuse of official information, the latter being the same charge that was leveled against the nurses. Both of the charges against Dr. Arafiles are third-degree felonies that carry a maximum sentence of 10 years in prison and a $10,000 fine.

In a case that alarmed advocates for whistle-blower protections, the two nurses were fired by the hospital and prosecuted in 2009 after anonymously reporting Dr. Arafiles for a variety of surgical and prescribing practices. After learning of the Texas Medical Board investigation, Dr. Arafiles consulted the sheriff in Winkler County, a personal friend, who seized the nurses’ computers and found their letter to the board, which included patient case numbers. Kermit, a town of 7,000 people about 400 miles west of Dallas, is the county seat.

The arrest warrant charged that Dr. Arafiles misused official information by asking a hospital employee to provide contact information for patients whose case numbers were listed in the nurses’ complaint. He then provided that information to the sheriff, who contacted the patients as part of his investigation.

Study: Christmas the Deadliest Day of the Year

From The National Post:

A new U.S. analysis of mortality rates during different times of year found that people are more likely to die during the holidays — notably on Christmas and New Year’s Day — and researchers cannot explain the yearly spike.

After analyzing all official United States death certificates over the 25-year period between 1979 and 2004, a trio of sociologists identified an excess of 42,325 natural deaths — that is, above and beyond the normal seasonal winter increase — in the two weeks starting with Christmas.

In the article in the journal Social Science & Medicine, researchers David Phillips, Gwendolyn Barker and Kimberly Brewer report that mortality in general rises during the Christmas season.

Deaths in a hospital setting increase tremendously on the holidays themselves.

More people die in hospital emergency wards, or arrive dead on arrival, on Christmas, Boxing Day and New Year’s Day than on any other days of the year.

“It’s not trivial,” said Mr. Phillips, a professor of sociology at the University of California at San Diego. “We looked at all cause categories and, for nearly every one, we found an excess of deaths — particularly for people who are dying rapidly, like dead-on-arrival or dying in the emergency department.”

Read more: http://news.nationalpost.com/2010/12/20/christmas-the-deadliest-day-of-the-year-study/#ixzz18rXNiy3x

For impatient patients, an urgent-care boomlet

Urban ER trends, reported by Crain’s New York Business–harbringer of trends in the rural ED?:

Urgent-care centers are springing up around Manhattan, a trend driven by emergency department doctors who see potential profit in steering New Yorkers clear of hospitals. Many impatient New Yorkers, they bet, would rather pay $150 to be treated within an hour than wait much longer than that in a hospital emergency room.

“In New York City—in Manhattan in particular—there’s a void in getting health care needs immediately serviced,” said Dr. Mark Melrose, who with business partner Dr. Neal Shipley opened Urgent Care Manhattan over the Thanksgiving weekend at 199 Amsterdam Ave., at West 69th Street. The board-certified emergency physicians honed their skills at Beth Israel Medical Center and New York-Presbyterian Hospital.

“Patients are fed up with long waits in the ER,” Dr. Shipley said. “We’re like the ‘easy’ button at Staples: You can see a board certified emergency physician with years of experience without an appointment in a city where you can’t even get your hair done without an appointment.”

Other emergency doctors are investing in the trend. These urgent-care centers aren’t affiliated with hospitals—although those also are proliferating—but are for-profit businesses run by entrepreneurial physicians.

Rural Physicians See Higher Average Compensation Than Those in Cities, Suburbs

From Becker’s Hospital Review:

The median cash compensation level for physicians in rural areas is higher than that of physicians in suburban and urban settings, according to data from Sullivan, Cotter and Associates.

Kim Mobley, a managing principal at SullivanCotter, says a few factors may contribute to the difference between urban and rural physicians. The difficulty rural hospitals face when recruiting specialists is the underlying issue beneath these differences. “The recruitment process is much more complex. In New York City, you might get 50 applications for a specialist position, but in North Dakota you might only get two,” says Ms. Mobley. With slow and difficult recruitment, it can take two to three years for some rural hospitals to hire the right physician. To some degree, rural hospitals may provide higher base compensation to simply attract physicians who may not want to move to rural settings.  

Also, rural areas do not typically have teaching hospitals. “Teaching hospitals tend to pay less because the faculty has a combination of clinical and academic work,” says Ms. Mobley. The data on which these figures are based includes teaching hospitals.

Many rural hospitals reflected in these figures may be located in health professional shortage areas, or areas medically underserved. Under Stark Law, hospitals within HPSAs may provide physicians with recruitment incentives. If physicians relocate their practice to the hospital’s geographic area, hospitals may offer relocating physicians incentives if they meet certain requirements. “This may include unique forms of payment, such as paying for loan forgiveness,” says Ms. Mobley. An emerging practice is to use retention bonuses to retain physicians in this competitive physician labor market.

In Rural Areas, There May Be No Doctors to Tend to Your Sick Kid

From Time’s Healthland:

Nearly 1 million American children living mostly in rural areas have no doctor to call if they get a get a sore throat or an ear infection. Meanwhile, some metropolitan areas are crawling with family physicians and pediatricians — about one doctor for every 140 kids in some places. As a result, children in more urban areas have better access to health care, reports a new study published online this week in the journal Pediatrics.

There are plenty of policy implications inherent in the study, but for parents, it comes down to this: you either have a doctor you can take your child to, or you don’t.

The new research shows there are essentially equal numbers of kids who live in areas of abundant supply or undersupply. There are 15 million children — 20% of kids in the U.S. — who live in areas where child health care is plentiful. But another 15 million live in enclaves in nearly every state where the ratio of pediatricians and family physicians is 22 for every 100,000 kids. That’s a patient load of more than 4,500 kids per doctor.

Read more: http://healthland.time.com/2010/12/21/sick-kid-if-you-live-in-a-rural-area-there-may-be-no-doctors/#ixzz18lmmTs82

Wellness Reading List: Five Top Picks of 2010

From the Wall Street Journal:

When it comes to books about medicine and health, people tend to crack them open in times of need: to research a medical problem, get advice on living a healthier lifestyle or find inspiration from fellow patients.

This year’s crop offers plenty of practical advice, including insights from doctors who shared their own experiences with a health crisis to illuminate the way for patients. Here are five that stood out among dozens that crossed my desk in 2010:

“After the Diagnosis: Transcending Chronic Illness,” by Julian Seifter with Betsy Seifter

“Back to Life After a Heart Crisis: A Doctor and His Wife Share Their 8-Step Cardiac Comeback Plan,” by Marc Wallack and Jamie Colby

“Stress Less: The New Science That Shows Women How to Rejuvenate the Body and the Mind,” by Thea Singer

“The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine,” by Tom Goetz

“Stay Healthy at Every Age: What Your Doctor Wants You to Know,” by Shantanu Nundy

Des Moines University names Franklin as new president

Des Moines University, the second oldest Osteopathic medical school and the fifteenth largest medical school (allopathic or osteopathic) in the United States, has named a new president.  From The Des Moines Register:

Des Moines University announced Monday that an administrator from a Tennessee medical school will become its next president.

Angela Walker Franklin will replace Terry Branstad, who retired in October 2009 to campaign successfully for his old job as governor.

Franklin is executive vice president and provost at Meharry Medical College in Nashville. The 800-student school has historically catered to black students studying medicine and related subjects. Des Moines University has 1,821 students in nine programs, including osteopathic medicine, podiatry and physical therapy.

She said Monday that she was attracted to Des Moines University’s emphasis on training health professionals to provide primary care. “There are a lot of schools that really focus more on research,” she said. “Now, not to say that Des Moines University doesn’t do research, but their primary reason for being is … delivery of health care in a very socially conscious kind of way, taking care of the needs of the people.”

Although she has not studied osteopathy, she said she appreciates its emphasis on considering patients’ entire situations, including their physical and mental health. “As a psychologist, that resonates quite a bit with me.”

Branstad, who was hired in 2003, was credited with raising millions of dollars for the university, sprucing up the campus and increasing enrollment 50 percent.

Franklin said the school still has the potential to grow, including by adding new programs. She declined to speculate on what those might be.